Rosy Tsopra1,2, Paul Frappe3,4,5,6, Sven Streit7, Ana Luisa Neves8,9, Persijn J Honkoop10, Ana Belen Espinosa-Gonzalez11, Berk Geroğlu12, Tobias Jahr13, Heidrun Lingner14,15, Katarzyna Nessler16,17, Gabriella Pesolillo18, Øyvind Stople Sivertsen19,20, Hans Thulesius21, Raluca Zoitanu22, Anita Burgun23,24, Shérazade Kinouani25,26. 1. INSERM, Université de Paris, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006, Paris, France. rosy.tsopra@nhs.net. 2. Department of Medical Informatics, Hôpital Européen Georges-Pompidou, AP-HP, Paris, France. rosy.tsopra@nhs.net. 3. Department of general practice, Faculty of medicine Jacques Lisfranc, University of Lyon, Saint-Etienne, France. 4. Inserm UMR 1059, Sainbiose DVH, University of Lyon, Saint-Etienne, France. 5. Inserm CIC-EC 1408, University of Lyon, Saint-Etienne, France. 6. College of General Practice / Collège de la Médecine Générale, Paris, France. 7. Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland. 8. Patient Safety Translational Research Centre, Institute of Global Health Innovation, Imperial College London, London, UK. 9. Center for Health Technology and Services Research / Department of Community Medicine, Health Information and Decision, Faculty of Medicine, University of Porto, Porto, Portugal. 10. Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands. 11. Imperial College London, London, UK. 12. İzmir Karşıyaka District Health Directorate, İzmir, Turkey. 13. Medizinische Hochschule Hannover, OE 5430, Carl Neuberg Str. 1, 30625, Hannover, Germany. 14. Medizinische Hochschule Hannover, Medizinische Psychologie, OE 5430, Hannover, Germany. 15. Member of the German Center for Lung Research (DZL)/ BREATH - Biomedical Research in Endstage and Obstructive Lung Disease Hannover, Carl Neuberg Str. 1, 30625, Hannover, Germany. 16. Department of Family Medicine, Jagiellonian University Medical College, Kraków, Poland. 17. Vasco da Gama Movement, Wonca Europe, Kraków, Poland. 18. ASL Teramo, Abruzzo, Italy. 19. Torshovdalen Health Center, Oslo, Norway. 20. Editor of the Journal of the Norwegian Medical Association, Oslo, Norway. 21. Lund University and Linneaus University, Lund, Sweden. 22. National Federation of Family Medicine Employers in Romania (FNPMF), București, Romania. 23. INSERM, Université de Paris, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006, Paris, France. 24. Department of Medical Informatics, Hôpital Européen Georges-Pompidou & Necker Children's Hospital, AP-HP, Paris, France. 25. INSERM, Bordeaux Population Health Research Center, team HEALTHY, UMR 1219, university of Bordeaux, F-33000, Bordeaux, France. 26. Department of General Practice, University of Bordeaux, 146 rue Léo Saignat, F-33000, Bordeaux, France.
Abstract
BACKGROUND: General practitioners (GPs) play a key role in managing the COVID-19 outbreak. However, they may encounter difficulties adapting their practices to the pandemic. We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the pandemic from 15 countries. METHODS: A network of GPs collaborated together in a three-step process: (i) identification of key recommendations of GP surgery reorganisation, according to WHO, CDC and health professional resources from health care facilities; (ii) collection of key recommendations included in the guidelines published in 15 countries; (iii) analysis, comparison and synthesis of the results. RESULTS: Recommendations for the reorganisation of GP surgeries of four types were identified: (i) reorganisation of GP consultations (cancelation of non-urgent consultations, follow-up via e-consultations), (ii) reorganisation of GP surgeries (area partitioning, visual alerts and signs, strict hygiene measures), (iii) reorganisation of medical examinations by GPs (equipment, hygiene, partial clinical examinations, patient education), (iv) reorganisation of GP staff (equipment, management, meetings, collaboration with the local community). CONCLUSIONS: We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the COVID-19 outbreak from 15 countries. These guidelines focus principally on clinical care, with less attention paid to staff management, and the area of epidemiological surveillance and research is largely neglected. The differences of guidelines between countries and the difficulty to apply them in routine care, highlight the need of advanced research in primary care. Thereby, primary care would be able to provide recommendations adapted to the real-world settings and with stronger evidence, which is especially necessary during pandemics.
BACKGROUND: General practitioners (GPs) play a key role in managing the COVID-19 outbreak. However, they may encounter difficulties adapting their practices to the pandemic. We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the pandemic from 15 countries. METHODS: A network of GPs collaborated together in a three-step process: (i) identification of key recommendations of GP surgery reorganisation, according to WHO, CDC and health professional resources from health care facilities; (ii) collection of key recommendations included in the guidelines published in 15 countries; (iii) analysis, comparison and synthesis of the results. RESULTS: Recommendations for the reorganisation of GP surgeries of four types were identified: (i) reorganisation of GP consultations (cancelation of non-urgent consultations, follow-up via e-consultations), (ii) reorganisation of GP surgeries (area partitioning, visual alerts and signs, strict hygiene measures), (iii) reorganisation of medical examinations by GPs (equipment, hygiene, partial clinical examinations, patient education), (iv) reorganisation of GP staff (equipment, management, meetings, collaboration with the local community). CONCLUSIONS: We provide here an analysis of guidelines for the reorganisation of GP surgeries during the beginning of the COVID-19 outbreak from 15 countries. These guidelines focus principally on clinical care, with less attention paid to staff management, and the area of epidemiological surveillance and research is largely neglected. The differences of guidelines between countries and the difficulty to apply them in routine care, highlight the need of advanced research in primary care. Thereby, primary care would be able to provide recommendations adapted to the real-world settings and with stronger evidence, which is especially necessary during pandemics.
Entities:
Keywords:
COVID-19; Clinical Practice Guidelines; General Practitioner; Pandemic; Primary care
Authors: Jayshree Bagaria; Tessa Jansen; Diogo Fp Marques; Mariette Hooiveld; Jim McMenamin; Simon de Lusignan; Ana-Maria Vilcu; Adam Meijer; Ana-Paula Rodrigues; Mia Brytting; Clara Mazagatos; Jade Cogdale; Sylvie van der Werf; Frederika Dijkstra; Raquel Guiomar; Theresa Enkirch; Marta Valenciano Journal: Euro Surveill Date: 2022-06